Injury Prevention

Injuries are the leading cause of hospitalization and death for Canadian children and youth between the ages of 1 and 19 years. Every 4 ½ days a child or youth in Saskatchewan dies and 38 are hospitalized due to an injury. The costs associated with injuries are enormous, not only in direct dollar costs, but more importantly in the loss of human life and potential. In 2010, child and adult injuries cost the province of Saskatchewan $1.1 billion, including direct costs to the healthcare system and indirect costs (e.g., reduced productivity, disability, premature death). Injuries however remain to be one of the least recognized public health problems today. Injury prevention plays a critical role in protecting the health of children and their families.

Injury prevention strategies address people’s behavior as well as the physical and social environment in which injuries occur through Education, Enforcement and Engineering.

There are two types of injuries: intentional and unintentional. Intentional injuries are the result of acts of violence such as suicide attempts, rape and assaults. Unintentional injuries are the result of falls, burns, drowning, motor vehicle incidents and other situations that are often referred to as “accidents”. “Accident” is a word used to describe common situations that seem to occur without a cause. When the word “accident” is used to describe situations resulting in unintentional injuries, most people assume that what happened was due to fate or chance. There are steps that can be taken however, to address the cause of injury and subsequently reduce the risk. Often these appropriate injury prevention steps are not taken and devastating injuries are the result. Unintentional injuries are devastating to the lives of individuals and families that experience them. Unintentional injuries are not “accidents”; they are predictable and preventable.

The language we choose is important. Using the term “accident” suggests that nothing can be done to prevent an injury. Most injuries are caused by events that are predictable, and thus, preventable. Young children are often injured when moving into a new developmental stage.

Injury Prevention throughout Ages and Stages

Learning and understanding the developmental stages of children is one way to create a safe environment in which our developing children can explore. There are no guarantees. Injuries will happen; bumps and bruises are a part of growing up. Parents and caregivers need to be concerned with injuries that are serious in nature and impair a child’s ability to go to school, play, or alter their life in some way.
Injuries often happen when caregivers are not directly supervising children. Direct supervision means that the caregiver is within an arm’s reach and looking at the child. Caregivers need to keep environments hazard-free while allowing children to explore, learn new skills, and test their own limits. Parents attuned to their children’s development will know when it is safe to give more freedom.

Be ready before the child is. Before a child develops a physical skill (e.g., crawl, walk, climb), parents and caregivers must recognize potential hazards. To determine where hazards are, look at the space(s) from the child’s point of view. Get down on your hands and knees and crawl around. Remove anything that is breakable or valuable and things they can pull down on themselves, or secure large items using anchors if it cannot be removed. The following charts outline prevention tips based on children’s physical developmental milestones. Every child will achieve these milestones at different ages; however, these are general guidelines of when parents can expect to see these abilities.

Prevention Tips and Safety Concerns

provide direct supervision – be physically close to the child and give the child undivided attention

do not hold hot liquids, like coffee, while caring for children

support an infant’s neck when held until he has muscle control

use a rear-facing car seat in the back seat of the vehicle

remove sharp, breakable, and small objects within reach of children

provide a safe sleep environment:

sleep in the same room as the child, but not in the same bed

always place baby on her back to sleep

do not put the child to sleep anywhere except her crib

use a crib made after 1986 with a solid frame that has sides that lock into place and a firm mattress that is tight against all four sides of the crib

do not use bumper pads, quilts, stuffed animals, pillows, railing, or toys

place the crib away from windows and cords

provide supervision during bath time and never leave an infant alone or in the care of another child while in water

have a plan to deal with frustration from caring for a crying baby – never shake a baby

keep a hand on the child when he is on an elevated surface, like a change table

check the temperature of bath water before placing your baby in it

turn down the temperature on your water heater

Developmental Milestones

roll from front to back

control head and neck movement

raise head and chest when lying on stomach

stretch out and kick legs when lying on stomach or back

push down with legs when feet are on a firm surface

bring hands to mouth

swipes at a hanging object

Prevention Tips and Safety Concerns

provide direct supervision – be physically close to the child and give the child undivided attention

move crib mattress to the lowest position once the child can pull himself up to standing

remove mobiles that the child may be able to reach when standing in his crib so he doesn’t pull things down onto himself

use a rear-facing car seat in the back seat of the vehicle

stairs should have a wall-mounted safety gate at the top of stairs and a pressure-mounted safety gate at the bottom to avoid falls

keep stairs free of clutter

make sure there is no furniture near windows or balcony railings

put window guards or child-resistant latches on all windows and screens

always use three-point safety straps on high chairs and strollers

keep the Poison Control Centre phone number (1-866-454-1212) nearby a phone and store poisons in a locked cupboard out of reach and out of sight

keep hot liquids out of reach of children

keep a hand on the child when he is on an elevated surface, like a change table

provide supervision during bath time

never leave an infant alone or in the care of another child while in water

do not place tobacco products (cigarettes, electronic cigarettes, cigars, pipes) and matches (lighters) within reach of children

do not leave your child alone in a vehicle

Developmental Milestones

roll

sit without help

support body weight on legs

control upper body and arms

move an object from hand to hand

use hands to explore an object

begin to put items in mouth

may be able to crawl or walk

may be able to pull into a standing position

Prevention Tips and Safety Concerns

provide direct supervision – be physically close to the child and give the child undivided attention

keep your child in a rear-facing seat as long as she fits within the weight restrictions of the seat (switch her to a front-facing car seat in the back seat of the car when she outgrows the rear-facing seat)

allow your child to play with toys meant for his/her age

keep indoor and outdoor poisonous plants away from children

use medication and vitamins that come in child-resistant containers

store cleaners out of reach of children

secure furniture to the wall

move child out of crib and into a low bed

keep hot liquid out of reach of children

use blinds that do not have long cords or use devices to secure the cords out of the reach of children

Developmental Milestones

Leading Causes of Injury

In Saskatchewan, the ten most common causes of injury-related hospitalizations for children and youth less than 20 years of age are: falls, sports-related, intentional self-harm, assault, unintentional poisoning, motor vehicle incidents, cycling, ATV, fire and burns, and pedestrian incidents. These injuries can occur in the home, in the yard, on the farm, in the city, at school, at the park, in the street, and anywhere else that a child or youth may be.

We all have the same goal – to be safe at home, at work, on the road, and at play. When children are playing in or around water, there is a risk of drowning. When drowning the body can’t get oxygen. The lungs and brain can be damaged. The good news is that drowning can be prevented.

What can you do to prevent a drowning?

Pay attention. While your child is in or near water, actively supervise. This means that children under 5 should be within an arm’s length of an adult. Older children also need supervision; take turns being the adult responsible for supervision.

Think ahead. Teach children the pool is off-limits without direct adult supervision. Empty paddling or wading pools when they are not being used.

Be prepared. Young children (under 3 years old) can drown in less than 2 inches of water and are not able to understand the dangers of water. Never leave a child unattended while in the bath or alone in a yard with a pool or hot tub.

Make your home safe. Add a 4 foot high fence around your pool. Don’t leave items (chair, table, play equipment) near the fence as a child could use it to climb over the fence. Drain the water after a bath. Leave toilet seats down when they are not in use. Cover rain barrels and hot tubs.

Teach safety skills. Enroll your child in swimming lessons and make sure he/she is comfortable and skilled in and around water. Teach children to tread water, swim with a buddy, and not enter water without an adult nearby.

Statistics

Injury for all ages of children and youth accounts for more deaths than all other causes of death combined. (Reaching for the Top. A Report by the advisor on healthy children and youth. Dr. K. Kellie Leitch. 2007)

Approximately 6,000 Canadian children sustain a major head injury which results in lifelong disability each year. (Reaching for the Top. A Report by the advisor on healthy children and youth. Dr. K. Kellie Leitch. 2007)

In 2004 Saskatchewan had the third highest per capita health care costs in Canada associated with injury, for all ages. Unintentional injury cost Saskatchewan $629 million, 399 lives lost and 192 lives changed due to permanent disabilities and 2,348 lives changed due to permanent partial disabilities in 2004. (The Economic Burden of Injury in Canada, SmartRisk. 2009)

Between 1995 and 2005 616 children and youth between birth and 19 years of age died from unintentional injuries due to motor vehicle incidents, drowning, fires, poisoning, falls, cycling incidents, pedestrian incidents and other (excluded self-injury and assaults). (Saskatchewan Comprehensive Injury Surveillance Report, 1995-2005. 2008)